Journal
CALCIFIED TISSUE INTERNATIONAL
Volume 104, Issue 1, Pages 14-25Publisher
SPRINGER
DOI: 10.1007/s00223-018-0467-4
Keywords
Radiogrammetry; Metacarpal indices; Bone strength; Fracture; Adolescents
Categories
Funding
- Wellcome Trust (UK)
- South African MRC
- National Research Foundation
- DST-NRF Centre of Excellence in Human Development at the University of the Witwatersrand
Ask authors/readers for more resources
This prospective study assessed whether metacarpal indices predict fracture risk in children and adolescents. Radiogrammetry was performed at the second metacarpal midshaft on annual hand-wrist radiographs of 359 South African (SA) children aged 10-17years. Bone length, bone width, and medullary width were measured, and the following proxies for bone strength calculated:metacarpal index (MCI), bone mineral density (BMD), section modulus (SM), stress-strain index (SSI), and slenderness index (SLI). Height and weight were measured annually. Self-reported physical activity (PA) and fracture history were obtained at ages 15years (for the preceding 12months) and 17years, respectively. At 17 years, 82 (23%) participants (black, 16%; white, 42%; p<0.001) reported a previous fracture. None of the bone measures or indices were associated with fracture in black participants. In white females, after adjusting for PA, a 1 standard deviation (SD) greater SLI doubled the fracture risk [odds ratio (OR) 2.08; 95% confidence interval (CI) 1.08, 3.98]. In white males, a 1 SD greater BMD was associated with a 2.62-fold increase in fracture risk (OR 3.62; 95% CI 1.22, 10.75), whilst a 1 SD greater SM (OR 2.29; 95% CI 1.07, 4.89) and SSI (OR 2.23; 95% CI 1.11, 4.47) were associated with a more than twofold increase in fracture risk, after height, and PA adjustment. No single index consistently predicted fracture across the four groups possibly due to ethnic and sex differences in bone geometry, muscle mass, and skeletal loading. Metacarpal radiogrammetry did not reliably predict fracture in SA children.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available